Medicare Updates MOON Advisory

Hospitals must supply both verbal and written notification to patients

An updated version of the Medicare Outpatient Observation Notice (MOON), which alerts Medicare beneficiaries about the potential coverage consequences of inpatient versus outpatient status at hospitals, has been issued by the Centers for Medicare and Medicaid Services (CMS), according to HealthLeaders Media.

Starting on March 6, 2017, hospitals will be required to present the MOON advisory both in writing and verbally to Medicare beneficiaries who receive at least 24 hours of hospital services under outpatient status.

Under the advisory, services for outpatient care in a hospital are generally paid by the beneficiary under Medicare Part B. Medicare beneficiaries admitted to hospitals as inpatients, however, have their services reimbursed at higher Part A rates.

In addition to giving Medicare beneficiaries advance warning about the three-day minimum inpatient-stay requirement for Part A reimbursement, the MOON advisory helps alert Medicare beneficiaries about the potential reimbursement consequences of the CMS’ “two midnight” rule, adopted in 2013. Under this rule, hospital stays for periods of less than two midnights are generally not considered appropriate for inpatient status unless a doctor orders such status. The MOON advisory tells Medicare beneficiaries that a doctor can order inpatient status for any hospital stays.

The MOON advisory was mandated under the Federal Notice of Observation Treatment and Implication for Care Eligibility Act, passed in August 2015. The advisory was also included in Medicare’s 2017 Inpatient Prospective Payment System final rule.

Source: HealthLeaders Media; December 8, 2016.